Learning How to Speak Again

By Alan Morales, WTC Stratcom

AW2 Soldier SGT Ian Ralston at an awards ceremony at the Minneapolis Veterans Affairs Medical Center.

When you say good night to a loved one or say thank you to a stranger, you use an ability that most of us take for granted—speech. After my interview with AW2 Soldier SGT Ian Ralston, I asked myself, how exactly do I speak? Do I first think about speaking? Do I tense my muscles and ligaments to form words? The reality is that for the vast majority of us, we don’t think about how we speak, we just speak. For Ralston, this was an ability he thought he had lost forever.

Ralston has very few recollections from the event that changed his life in Taji, Iraq. It was July 2010 when his vehicle was attacked by an improvised explosive device (IED) hanging from the ceiling of a concrete overpass. Ralston describes, “It was like the movies. Everything turned to slow motion, my hearing was muffled, and all I could hear were the voices of other Soldiers crying out to me, asking if I was okay. Then, it all turned to black.”

A few weeks later in Landstuhl, Germany, a physician informed Ralston about his injury. Heavily sedated at the time, however, he doesn’t remember talking to a doctor and it wasn’t until he was at Walter Reed Army Medical Center in Washington, DC, when he truly understood his injuries. His first clear memory since the attack in Iraq, he awoke, stared at his Family, and tried to speak. That’s when he knew and thought to himself, “I will never speak again.”

The IED attack paralyzed him from the neck down, preventing him from speaking or eating. He eventually had a tracheotomy tube placed in his throat to help him breathe; however, after a few days, started to choke. The doctors quickly removed the tube from his throat and realized he was trying to mouth words. This was the first day of his journey to learn how to speak once again.

Ralston spent weeks working with speech therapists to relearn how to speak and eat. Because certain parts of his throat did not completely regain the ability to move, he had to learn alternative ways to shape syllables and vowels. He walked a tightrope, balancing positive and negative emotions that often left him spiritually drained. He described, “I was scared. I spent a month in bed doing nothing. Now, I was trying to speak, working so hard and not getting very far. I felt exhausted. I often thought to myself, this is just a waste of my time.”

Nevertheless, inspiration came from another source. Ralston was accompanied by his Family members who took turns driving the 12 hours from their hometown in Iowa to Walter Reed every week to be with him. The dedication of his Family shed light on his opportunity to regain what he thought he had lost. As Ralston explained to me, it wasn’t just the chance to speak again, it was the chance to say, “I love you” to his girlfriend or even simply tell a joke. He became inspired and chose not to look at each day’s progress, but the overall journey. He quickly became determined to make his dream a reality if not for him, for his Family and loved ones.

“I am very self-driven and don’t try to let obstacles get in my path and trip me up,” shared Ralston. “I stay positive. I stay motivated for my Family. Back then, I knew that if I pushed myself, then I could improve my life and improve theirs.” It took him approximately four weeks to relearn how to enunciate words and be able to digest more than a few ice chips. On the phone, I remarked at his ability to speak. I realized that for each word, he had to learn how to recalibrate his brain so his throat muscles could correctly mouth and vocalize words. I realized that speaking is no longer intuitive for him.

Before ending the telephone interview, I asked Ralston about the future. He shared with me that he intends to attend college and earn a bachelor’s degree in history to pursue a teaching career. When asked why teaching, he responded, “As a former trainer in the Army, it’s a good feeling when you realize what you are saying is getting through to your students. You get to see their eyes light up.” I ventured to say that the feeling must be similar to what he felt when he first spoke to his Family and girlfriend. It was a spark that inspired them and inspired Ralston to continue driving forward.